CLINICAL TRIAL article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1451965
This article is part of the Research TopicNew Approaches to Neoadjuvant Therapy and Translational Resection in Hepatobiliary MalignanciesView all 10 articles
Conversion Therapy with TACE, TKIs, and ICIs for Unresectable BCLC Stage B and C Hepatocellular Carcinoma
Provisionally accepted
- 1Eastern Hepatobiliary Surgery Hospital, Shanghai, China
- 2Second Military Medical University, Shanghai, Shanghai Municipality, China
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Background and aims: Most Hepatocellular carcinoma (HCC) diagnoses occur at advanced stages precluding radical surgical resections. Conversion therapy offers a viable chance for patients with unresectable HCC (uHCC) to become eligible for curative surgery. Despite the application of various treatment modalities for conversion therapy, uncertainties persist regarding its efficacy. Consequently, we collected clinical data to evaluate the prognosis of TACE+TKI+ICI conversion therapy and compared it with the prognoses of other conversion therapies in the literature. We aimed to elucidate the potential superiority of triplet therapy as the optimal option among the existing conversion therapy regimens, by using this comprehensive analysis.Methods: From January, 2019, to November, 2022, we collected data from 69 patients with HCC undergoing conversion therapy with the TACE+TKI+ICI triplet therapy. Ultimately, we analyzed data from 57 patients at BCLC Stages B and C in our study. We also conducted a comprehensive literature review on conversion therapy for uHCC by searching PubMed and Web of Science databases and gathered data from 9 studies comprising a total of 560 patients.The conversion and disease control rate (DCR) in our cohort reached 14.0% (95% CI, 9.4-18.6%) and 66.7% (95% CI, 60.5-72.9%), respectively. When compared to the conversion rates in the literature, the triplet therapy demonstrated significant benefits, underscoring the potential efficacy of the TACE+TKI+ICIs triplet therapy.Our results presented improved conversion rates in patients with uHCC following TACE+TKI+ICI triplet therapy. However, overall survival (OS) and recurrence-free survival (RFS) were similar to those of other treatment modalities in the literature. (ClinicalTrials.gov number, ChiCTR2400084896)
Keywords: Hepatocellular Carcinoma, TACE, anti-angiogenic therapy, Anti-PD-1 antibody, Conversion therapy
Received: 20 Jun 2024; Accepted: 26 May 2025.
Copyright: © 2025 Wang, Zhang, Yin and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianhua Yin, Second Military Medical University, Shanghai, 200433, Shanghai Municipality, China
Nan Li, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.